Dettenborn Therese, Wermker Kai, Schulze Hans-Joachim, Klein Martin, Schwipper Volker, Hallermann Christian
Department of Plastic Surgery (Head Dr. A. Krause-Bergmann), Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany.
Department of Oral and Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. M. Klein), Head and Neck Cancer Centre, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany.
J Craniomaxillofac Surg. 2014 Dec;42(8):1623-8. doi: 10.1016/j.jcms.2014.05.002. Epub 2014 May 15.
Cutaneous angiosarcoma of the head and neck (cAS-HN) is a rare malignancy with poor survival. Most of the histological markers and grading were not proven to be significant for prediction of outcomes in cAS-HN. This study aimed to find prognostic clinical features and histologic markers for cAS-HN.
We retrospectively analysed primary cAS-HN's seen in a single institution between 1980 and 2009. Clinical data and specific histologic characteristics were assessed. Outcome parameters were analysed using uni- and multivariate statistics.
80 patients (mean age 71.4 (SD 14.4) years, average follow-up time 55.3 (SD 74.4) months) were included. 5-year DSS rate was 62%. Univariate analysis revealed the extent of primary tumour (affecting more than one anatomical region), incomplete resection and initial metastatic disease as significant (p < 0.05) predictors for unfavourable disease specific survival (DSS) rates and time. Multivariate analysis confirmed age over 70 years, incomplete resection and initially distant metastasis influencing outcome adversely. Analysis of specific histological markers in 37 cases found patterns of growth (solid areas greater than 80%) associated with better survival (p = 0.011).
In conclusion age, number of affected regions, initial metastasis, complete initial resection and pattern of growth significantly affected mortality rates.
头颈部皮肤血管肉瘤(cAS-HN)是一种罕见的恶性肿瘤,生存率低。大多数组织学标志物和分级对预测cAS-HN的预后并无显著意义。本研究旨在寻找cAS-HN的预后临床特征和组织学标志物。
我们回顾性分析了1980年至2009年间在单一机构中所见的原发性cAS-HN病例。评估了临床数据和特定的组织学特征。使用单变量和多变量统计分析结果参数。
纳入80例患者(平均年龄71.4(标准差14.4)岁,平均随访时间55.3(标准差74.4)个月)。5年疾病特异性生存率(DSS)为62%。单变量分析显示,原发性肿瘤范围(累及多个解剖区域)、不完全切除和初始转移性疾病是疾病特异性生存率(DSS)和生存时间的显著(p<0.05)不利预测因素。多变量分析证实,70岁以上、不完全切除和初始远处转移对预后有不利影响。对37例病例的特定组织学标志物分析发现,生长模式(实性区域大于80%)与更好的生存率相关(p=0.011)。
总之,年龄、受累区域数量、初始转移、初始完全切除和生长模式显著影响死亡率。